Estrogen Medication Affecting the Reproductive System/wk2 Flashcards
Estrogens: Expected Pharmacological Action Needed for growth and maturation of female reproductive tract
Secondary sex characteristics
Estrogen blocks… blocks bone resorption…so strong bones
reduces low density lipoproteins (LDL) levels “Bad cholesterols”
Estrogen at High Levels does what to FSH? Suppress the release of follicle-stimulating hormone
Estrogen: Therapeutic Uses Contraception
Relief of moderate to severe postmenopausal systems
eg: Hot flashes, mood changes
Prevention postmenopausal osteoporosis
TX: dysfxn uterine bleeding, prostate cancer, vulvar atrophy
Estrogen discontinue prior to…surgery? Discontinue prior to knee/hip or any surgery that may cause extensive immobilization
Estrogen: Route of administration Oral
transdermal: trunk only
intravaginal
IM, IV
Endometrial and ovarian cancers when prolonged estrogen is the only postmenopausal therapy
Estrogen: Adverse effects & Nursing intervention Admin estrogen with progestin
pt report prolong vaginal bleeding if uterus intact
Advise pt to have endometrial biopsy every 2 years and yearly pelvic exam
Risk for estrogen-dependent breast cancer
Estrogen: Adverse effects & Nursing intervention Rule out estrogen dependent breast cancer before starting therapy
Pt examine breast regularly
Yearly MD breast exam
periodic mamograms
Embolic Events: MI, PE, DVT, stroke
Women over 60 have increased risk of MI and CHD
Estrogen: Adverse effects & Nursing intervention Avoid all nicotine products
monitor for pain swelling, warmth or erythema of lower legs
Teach client how to reduce risk of CVD
Pregnancy Risk Category
Estrogen Contraindications/Precautions Category X: Positive evidence of fetal risk based on studies of both animal and human
Contraindicated for clients who have:
Estrogen Contraindications/Precautions Client or family Hx of heart disease
abnormal vaginal bleeding undiagnosed
breast or estrogen dependent cancer
Hx or risk of thromboembolic disease
Use cautiously during breastfeeding because…?
Estrogen Contraindications/Precautions Estrogen decreases quantity and quality of milk and mbe excreted in breast milk
Use cautiously in prepubescent girls because…?
Estrogen Contraindications/Precautions If administered monitor
bone growth
check periodically for early epiphyseal plate closure
Warfarin (Coumadin)
Medication/Food Interactions Can reduce effectiveness of Coumadin
if used concurrently monitor INR and PT
Warfarin doses may need to be adjusted
Phenytoin (Dilantin)
Medication/Food Interactions Can reduce effectiveness of ESTROGENS
monitor for decrease estrogen effects
Corticosteroids
Medication/Food Interactions May increase effects of estrogen
monitor or increase estrogen effects
Smoking
Medication/Food Interactions Increases risk of thrombophlebitis
advise pt not to smoke
use alternative TX in smoking persist
Estrogen Nursing Duties take med same time each day
patch on trunk
menstrual changes
breast and GYN exam
Swelling/redness in legs call MD
Discontinue use before knee/hip or surgery where pt will be immobile for extensive period to time
Estrogen Nursing Evaluation No conception
Relief of severe postmenopausal symptoms
reduce uterine bleeding
decrease spread of prostate cancer
Estrogen (estradiol) levels
During ovulation
During menstruation
During pregnancy
After menopause During ovulation 400 pg/ml
During menstruation 45 pg/ml
During pregnancy 100 times greater with fluctuations
After menopause 10-20 pg/ml hormone therapy advised to attain level of 40-50 pg/ml, maintain bone health
Causes for estrogen level drops Hysterectomy, chemotherapy, autoimmune, decrease body weigh, low body fat, radiation, menopause
Causes for estrogen level increase Overweight, high blood pressure, diabetes, pregnancy, taking drugs with estrogen in them
Estrogen primarily produced by ovaries
Vulvar Atropy Thinning, inflammation, dryness of vaginal wall
Follicle-stimulating hormone needed for conception
LDL: fxn cholesterol cannot travel in blood it must be carried from cell to cell via LDL or HDL
LDL: Normal Level …
mmm
